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Treating Patients with Type 2 Diabetes Mellitus Uncontrolled on Basal Insulin in the Czech Republic: Cost-Effectiveness of IDegLira Versus iGlarLixi.

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العنوان: Treating Patients with Type 2 Diabetes Mellitus Uncontrolled on Basal Insulin in the Czech Republic: Cost-Effectiveness of IDegLira Versus iGlarLixi.
المؤلفون: Pöhlmann, Johannes1 (AUTHOR) poehlmann@ossianconsulting.com, Russel-Szymczyk, Monika2 (AUTHOR), Holík, Pavel3 (AUTHOR), Rychna, Karel3 (AUTHOR), Hunt, Barnaby1 (AUTHOR)
المصدر: Diabetes Therapy. Apr2019, Vol. 10 Issue 2, p493-508. 16p.
مصطلحات موضوعية: *TYPE 2 diabetes, *GLUCAGON-like peptide-1 receptor, *INSULIN, *GLUCAGON-like peptide-1 agonists, *QUALITY-adjusted life years, *GLYCEMIC control
مصطلحات جغرافية: CZECH Republic
الشركة/الكيان: NOVO Nordisk A/S NVO
مستخلص: Introduction: Few patients with type 2 diabetes mellitus (T2DM) achieve recommended glycemic control targets in the Czech Republic. Novel therapies, such as fixed-ratio combinations of basal insulin plus glucagon-like peptide-1 receptor agonists, may contribute to better glycemic control. In the analysis presented here, the present analysis assessed the long-term cost-effectiveness of two fixed-ratio combinations, IDegLira (insulin degludec/liraglutide) and iGlarLixi (insulin glargine/lixisenatide), for the treatment of patients with T2DM inadequately controlled with basal insulin from a healthcare payer perspective in the Czech Republic. Methods: A cost-effectiveness analysis was performed over patient lifetimes using the IQVIA CORE Diabetes Model. Treatment effects were obtained from an indirect treatment comparison as no head-to-head data for IDegLira versus iGlarLixi are currently available. IDegLira was compared with two iGlarLixi pens (100 U/mL insulin glargine + 33 μg/mL and 50 μg/mL of lixisenatide, respectively). Direct medical costs associated with pharmaceutical interventions, screening and diabetes-related complications were captured. Deterministic and probabilistic sensitivity analyses were performed. Results: IDegLira was associated with gains in life expectancy of 0.11 years and in quality-adjusted life expectancy of 0.14 quality-adjusted life-years (QALYs) versus iGlarLixi, due to a lower cumulative incidence and delayed onset of diabetes-related complications. IDegLira was also associated with higher projected costs due to higher acquisition costs; however, these were partially offset by cost savings from avoided complications. IDegLira was associated with incremental cost-effectiveness ratios of Czech Koruna (CZK) 695,998 and CZK 348,323 per QALY gained versus iGlarLixi pens containing 33 and 50 μg/mL of lixisenatide, respectively. These ratios were below the commonly used willingness-to-pay threshold of CZK 1,200,000 per QALY gained. Conclusion: The present analysis indicated that IDegLira was associated with clinical benefits relative to iGlarLixi over patient lifetimes and was likely to be cost-effective in the treatment of patients with T2DM uncontrolled on basal insulin in the Czech Republic. Funding: Novo Nordisk. Plain Language Summary: Plain language summary is available for this article. [ABSTRACT FROM AUTHOR]
قاعدة البيانات: Academic Search Index
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